Words Matter. Tax Cuts Will Hurt, Not Help America Final Week in Health Care Sabotage – 2017 ACA Open Enrollment Over in Most States Social Isolation Among Older Medicare Beneficiaries Reminder: Objections to "Homebound" … [Read more...] about CMA Alert – Tax Cuts will Hurt, Not Help; Sherman Fairness Hearing Set; “Homebound” Settlement Objections Due; More
Litigation
CMA Alert – It’s Enrollment Season; CMS Reissues HH Booklet; “Homebound” Case Settlement; More
It's Health Care Enrollment Season NEW! CMS Again Reissues Improved Medicare Home Health Booklet THIS Week In ACA Sabotage... Happy Anniversary SSI Medicare "Homebound" Class Action Settled – Fairness Hearing Set … [Read more...] about CMA Alert – It’s Enrollment Season; CMS Reissues HH Booklet; “Homebound” Case Settlement; More
Olsen-Ecker v. Burwell
No. 3:15-cv-1468-JAM, filed October 9, 2015Issue: Whether the extremely high denial rates (98% and higher) at the redetermination and reconsideration stages of administrative review for home health care claims violate the Medicare statute and the … [Read more...] about Olsen-Ecker v. Burwell
Bremby v. Burwell
No. 3:15-cv-01397 (DJS), filed September 22, 2015Issue: Whether the Secretary violated the Medicare statute and the Due Process Clause by not recognizing that Vitamin B-12 injections represent a per se skilled nursing service and therefore the … [Read more...] about Bremby v. Burwell
Lodge v. Burwell
No. 3:15-cv-00390-JBA (D.Conn.), filed March 17, 2015Issue: Whether extraordinary dental care should be covered because the exclusion for coverage of dental care should be limited to routine dental care.Relief Sought: Reversal of the Secretary’s … [Read more...] about Lodge v. Burwell
Ryan v. Burwell
No. 5:14-cv-269 (D.Vt.), filed Dec. 19, 2014Issue: Whether the failure of the Secretary to apply the “prior favorable homebound decision” rule, which accords “great weight” to previous administrative decisions establishing homebound status, … [Read more...] about Ryan v. Burwell
Lessler v. Burwell
No. 3:14-cv-01230 (D.Conn.), filed August 26, 2014Issue: Whether the consistent failure of administrative law judges (ALJs) to issue decisions within 90 days of the request for ALJ review (with an average delay now approaching 500 days) … [Read more...] about Lessler v. Burwell
Haro v. Johnson
No. 09-cv-134-TUC-DCB (D.Ariz.), filed March 10, 2009. Appeal filed June 30, 2011 (No. 11-16606, 9th Cir.).Issue: Whether the Secretary's aggressive methods for attempting to collect payments under his Medicare Secondary Payer (MSP) program, … [Read more...] about Haro v. Johnson
Hull v. Sebelius
No. 14-801 (D.Conn.), filed June 4, 2014Issue: Whether the Secretary of Health & Human Services’ denial rate of about 98% at the lowest two levels of appeal in Medicare’s system of administrative review (redetermination and reconsideration) … [Read more...] about Hull v. Sebelius
New Beneficiary Help Line for ALJ Appeals Results from CMA Litigation
Pursuant to the settlement agreement in Exley v. Burwell, a class action brought by the Center to address delays in appeals at the Administrative Law Judge (ALJ ) level, the Office of Medicare Hearings and Appeals (OMHA) has established a new help … [Read more...] about New Beneficiary Help Line for ALJ Appeals Results from CMA Litigation